Information
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Document No.
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Conducted on
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Prepared by
Owner or Tenant Details
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Owner or Tenant Name
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Addresss
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Officer Name
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I have been advised by the above mention Officer of the following:
1. of the purpose of entering the property;
2. that anything or information found on the property may be used as evidence in court;
3. agreement to entry was voluntarily given by me; and
4. I was not obliged to give permission to enter the property.
I agree to the entry for the purpose of exercising powers under Chapter 5 of the Local Government Act 2009.
I have received a copy of this document. -
Occupier's Signature
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Authorised Person's Signature
